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One prescription: For treating Gu Zhang (abdominal distension resembling a drum, accompanied by parasitic accumulation or internal retention of water and dampness) resulting in a dry body, dark and emaciated complexion, excessive thirst, irritability, and oppression. Use Ma Bian Cao (Patrinia Herba), finely chopped and sun-dried, avoiding fire. Decoct with wine or water. Remove the dregs when the flavor is gone, and take warm at any time. It is effective if harvested during thunderstorms in mid-June.

Another prescription: For treating Shui Gu (accumulation disease characterized primarily by ascites), regardless of the duration of onset. For deep-seated cases, use Da Ji (Kansui Radix), Dang Gui (Angelicae Sinensis Radix), and Chen Pi (Citri Reticulatae Pericarpium), each one liang. Finely chop, add two sheng of water, decoct to seven-tenths, and take in one dose. If two or three dou of abnormal matter (such as blood stasis or fluid) is discharged, for severe cases with obstruction, administer again.

(Attached: Jia and Pi)

Su Wen (Basic Questions) and Zhen Jing (Needle Classic) state: Ji (accumulation; fixed abdominal masses with definite location and pain) arises from Jue Qi (rebellious qi) originating in the feet, leading to cold in the lower legs. Cold in the lower legs causes blood vessels to become stagnant and sluggish. Stagnation allows cold qi to ascend into the stomach and intestines, causing abdominal distension. Distension forces the fluids and foam outside the intestines to gather and not disperse, gradually forming an accumulation. Sudden overeating leads to intestinal fullness. Irregular lifestyle and excessive exertion damage the collaterals. Damage to Yang collaterals causes external bleeding, manifesting as epistaxis; damage to Yin collaterals causes internal bleeding, manifesting as hematochezia. Damage to the collaterals of the stomach and intestines causes blood to overflow outside the intestines. If cold and fluid foam contend with blood, they mix and coagulate without dispersing, forming an accumulation. Alternatively, external injury to cold and internal injury to sorrow and anger cause qi to rebel upward. Upward rebellion obstructs the Six Shu points (acupoints where qi and blood transport), preventing the movement of warming qi. Coagulated blood remains inside without dispersing, and fluid secretion becomes sluggish. Adhesion and non-dispersion ultimately result in accumulation. It is also stated that excessive thinking causes qi to knot, which over time forms accumulation.

In the Chapter on Rare Diseases, the Yellow Emperor asked: The hypochondrium is full, qi rebels upward, and this persists for two or three years. What disease is this? Qibo replied: The disease is named Xi Ji (breathing accumulation). This condition does not interfere with eating. Moxibustion and acupuncture are contraindicated. Accumulation requires Dao Yin (ancient therapeutic exercises) combined with herbal medicine; herbs alone cannot cure it independently.

According to the theory of Five Movements and Six Qi, accumulations generally belong to Damp Earth. The classics state: When Earth qi is excessive, it is called the Era of Dun Fu (solid mounds). Its manifestations include dampness, accumulation, and convulsions.

The Chapter on Generation of the Five Viscera states: When the red pulse arrives rapid and firm, the diagnosis indicates accumulated qi in the center, occasionally hindering food intake. This is named Xin Bi (heart bi-syndrome), acquired from external diseases. Due to excessive thinking, heart qi becomes deficient, allowing pathogenic factors to enter. When the white pulse arrives rapid and floating, indicating deficiency above and excess below, with fright, there is accumulated qi in the chest. It presents with asthma and deficiency, named Fei Bi (lung bi-syndrome), with chills and fever, caused by sexual intercourse after drunkenness. When the green pulse arrives long and pulses left and right, there is accumulated qi supporting beneath the heart, named Gan Bi (liver bi-syndrome), caused by cold-dampness, treated similarly to Shan syndrome (hernia), with symptoms of lumbar pain, cold feet, and tight head pulses. When the yellow pulse arrives large and deficient, there is accumulated qi in the abdomen and Jue Qi (rebellious qi), named Jue Shan (rebellious hernia), with the same treatment for women, caused by strenuous limb activity and exposure to wind while sweating. When the black pulse arrives firm and large above, there is accumulated qi in the lower abdomen and yin organs, named Shen Bi (kidney bi-syndrome), caused by bathing while cold and lying down.

Nan Jing (Classic of Difficult Issues) states: Ji (accumulation) is Yin qi; Ju (gathering) is Yang qi. Therefore, Yang floats and moves, while Yin sinks and hides. Where qi accumulates, it is called Ji; where qi gathers, it is called Ju. Thus, Ji arises from the Five Zang organs; Ju is formed by the Six Fu organs. Ji is Yin qi; its onset has a constant location, pain does not leave its area, and it has specific upper/lower and left/right boundaries. Ju is Yang qi; its onset has no root, no fixed upper/lower stopping point, and pain occurs in variable locations. This is how Ji and Ju are distinguished.

It further asks: Do the accumulations of the five viscera have specific names? The accumulation of the liver is named Fei Qi (fat qi), located under the left hypochondrium, like an inverted cup, with a head and feet. If not cured for a long time, it causes cough, rebellious qi, aphonia, and malaria, persisting for years. It is acquired on Wu-Ji days in late summer. Why? Lung disease transmits to the Liver, and the Liver should transmit to the Spleen. In late summer, the Spleen is prosperous and does not accept pathogens. The Liver attempts to return the pathogen to the Lung, but the Lung refuses to accept it, so it stays and knots to form accumulation. Hence, Fei Qi is acquired on Wu-Ji days in late summer. (Xu Chunfu notes: It is logical that accumulation transmits to what it overcomes, and the prosperous qi does not accept pathogens. It is also logical that liver accumulation originates from lung metal and is acquired in late summer. However, stating that the liver tries to return to the lung and the lung refuses, specifically on Wu-Ji days, seems overly rigid. If the wood qi is diseased itself, rather than transmitted via overcoming relationships, such cases also exist. Why be constrained by this?)

The accumulation of the heart is named Fu Liang (hidden beam), starting above the umbilicus, as thick as an arm, extending up to below the heart. If not cured for a long time, it causes vexation and anxiety. The accumulation of the spleen is named Pi Qi (stagnant qi), in the epigastrium, as large as a plate. If not cured for a long time, it causes inability to move the four limbs, jaundice, and failure of diet to nourish muscles. The accumulation of the lung is named Xi Ben (gasping accumulation), under the right hypochondrium, covering an area as large as a cup. If not cured for a long time, it causes aversion to cold and fever, asthma, cough, and may lead to Lung Abscess. The accumulation of the kidney is named Ben Tun (flying pig), originating in the lower abdomen, extending up to below the heart, resembling a pig running, moving up and down without fixed times. If not cured for a long time, it causes wheezing, bone萎 (weakness), and shortness of breath.

Yuan Bing Shi states: Accumulation and gathering arise from the lack of harmony between Yin and Yang, weakness of the zang-fu organs, or invasion by wind pathogens contending with the qi of the zang-fu organs.

Chao Shi Bing Yuan states: Persistent accumulation and knotting occur when the qi of the five zang and six fu organs has already accumulated internally, compounded by irregular diet, improper adjustment to cold and heat, and overlapping pathogenic factors, resulting in firm and hard knotting. If prolonged, it becomes Zheng Jia (fixed masses).

Yu Ji Wei Yi states: Accumulation and gathering are mostly caused by diet and the Seven Emotions (joy, anger, worry, thought, grief, fear, fright). Mr. Hua (Hua Shou) believed this follows the intent of Yue Ren (Bian Que), deducing the inevitable trends based on the principles of the Five Elements and elaborating them into text. Initially, one need not discuss emotional factors, nor whether transmission returns, or whether it is inevitable. Readers should simply treat based on the principle that "what is overcome transmits to the overcomer" and "the prosperous qi does not accept pathogens, thus leaving knots to form accumulation."